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IHP News 610 : Perseverance

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IHP News 610 : Perseverance IHP news 610 : Perseverance ( 26 Feb 2021) The weekly International Health Policies (IHP) newsletter is an initiative of the Health Policy unit at the Institute of Tropical Medicine in Antwerp, Belgium. Dear Colleagues, When the first vaccine doses distributed by COVAX landed in Ghana earlier this week, it felt a bit like the Perseverance’s landing on Mars. Ouf! At last. Neil Armstrong probably also nodded approvingly from heaven, when hearing some of the rhetoric: “Wonderful words from @UNICEF Covax Coordinator Gian Gandhi as the first ACTA flight hits the ground in Ghana: « A short flight, and small step to reduce inequities in vaccine access... but a huge achievement that’s been almost 10 months in the making». Anyway, encouraging and great news, not a day too soon. Still, the picture on global vaccine equity remains bleak in the short term, for the reasons you know. Yes, there is a growing movement behind vaccine equity, as dr. Tedros claimed last week, and multilateralism made a cautious comeback at the G7 summit (with Covax getting a (much needed) shot in the arm). WHO officials can now be (a bit) more optimistic about successfully getting around 2 billion vaccine doses to at least 20% of the populations of 92 lower-income economies by the end of 2021. But they shouldn’t get carried away too soon, as this (excellent) COVAX “state of affairs” piece in Stat argued: “more is needed to ensure global vaccine access”. A quote from Kenneth Shadlen put things in perspective: “It would be great if COVAX can help us avoid a worst-case scenario of poor countries having no vaccines until 2022 or later. That’s an accomplishment that we can celebrate, but we should also recognize the accomplishment for what it is – avoiding a worst- case scenario.” Even if there are probably also epidemiological and cost-effectiveness arguments complicating the vaccine equity debate a bit in some (of the relatively less hit) regions of the world, the last thing you want in this pandemic is that social spending in LMICs gets cut even more than already is the case, because they have to purchase vaccines at "above rich world" prices. Over here in Europe, ‘Team Europe’ and Emmanuel Macron’s version of global solidarity continues to contain a strong dose of geopolitics, but perhaps that was always unavoidable, given how most leaders are wired. What is far less unavoidable, though, is the continued opposition of rich countries (with big pharmaceutical industries) to the TRIPS waiver proposal, where things remain deadlocked. Against that backdrop, the question has to be raised, as Sophie Harman pointed out in a tweet, “whether COVAX was set up to avoid any discussion on IP and TRIPs waivers for COVID vaccines. Is COVAX part of problem not solution to #PeoplesVaccine?” I wouldn’t go that far. COVAX (and ACT-A) are no doubt needed on the journey towards a “People’s Vaccine” in this grossly unfair and imperfect world of ours, even if they clearly don’t suffice. On the latter, Nick Dearden (Global Justice Now), put it like this after the G7 meeting: “The Elephant in the Zoom” remains Big Pharma patents. And so, borrowing a line from NASA, I hope global civil society ‘Perseveres’ with its essential battle to overcome the artificially constrained supply, and (in the process) the current global vaccine distribution “zero-sum game”. Fortunately, People’s Vaccine proponents have some great allies like Winnie Byanyima and John Nkengasong – not to mention the 1 Holy See! And perhaps dr. Tedros can also give a hand, by tweeting on the TRIPS waiver: ‘Perseverance’ ? Over to the US administration then, and the “new wind” that comes with it . When I see Joe Biden’s calm demeanor, just “getting to business” and “doing what needs to be done”, I wonder to what extent you also see the (somewhat sad) difference between (at least some) in his generation, and the “neoliberalized individuals” we have all become in the past 30 years, consciously or subconsciously, (self-)branding and competing with each other all the way till the very destruction of our planet. I’m not a big fan of Branko Milanovic’s writings on degrowth, but sadly, this assessment in a blog by him this week was spot on: “capitalism, and thus both the relentless search for profit and the value system that places wealth on the pedestal, is more dominant than ever. Had degrowers preached material abstinence in 13th century Europe or 10th century Byzantium it might have had more appeal. Commercial society, capitalism, numerical abilities were far less developed than today. But now, the relevance of moral preaching of abstinence is close to zero. …”. But let’s end this intro with dr. Tedros. As some pointed out, WHO statements targeting specific countries are rare, but Tedros did single out Tanzania last week (for good reason). At Monday’s WHO media briefing, dr. Tedros also lashed out at High-Income countries for snapping up vaccine supplies. No prizes to be won for which criticism is most important in this world of ours. Enjoy your reading. Kristof Decoster Featured Article The Future of Global Health Leadership: reflections of the IWG Fireside Chat Ghiwa Nasser Eddine, Laura Haywood, Malvikha Manoj, Magali Collonnaz (all are IWG members) The International Working Group for Health Systems Strengthening (IWG) is an international collaborative of emerging public health professionals committed to meaningful health systems reform. To better understand what makes a leader, we hosted a fireside chat in December, called ‘Looking Back, Looking Forward’, with three trailblazers in their fields: Dr. Kabir Sheikh, Dr. Rene Loewenson, and Dr. Roopa Dhatt. The discussion aimed to explore the paths that these three individuals have paved in the field of global health and to inspire conversations and actions for reform. Three essential lessons emerged: 1. Advocacy rooted in core values: Identifying a core vision, mission, and goals, and centering them within a strong value system that can guide your advocacy efforts, can help rally other like-minded collaborators towards your cause. 2 2. Collective successes over Individual successes: In public health, as is common across many other spaces, the success of one requires the success of many. 3. People-centered comprehensive public health: Public health professionals should always consider, engage and work with the members of the community as the most critical aspect of every initiative they intend to implement. Following this, IWG members had a ‘think in’ to reflect on the speakers’ ideas and collate different recommendations that emerging public health professionals may consider insightful in setting their own paths. Study the history of global health, and critically examine who holds power as well as how your work shapes the distribution of power. Global health emerged from a colonial legacy and it could be argued that these tendencies are still perpetuated in modern times in different ways. Power imbalances across gender, race, and geography are still abundant in the space. As emerging global health leaders, we have a responsibility to question how this history has shaped the mistrust and division that exists within public health, and then commit to tangible actions to address these issues. Identify, adhere to, and come back to your values and convictions regularly. Values can be critical drivers that shape aspirations and intentions in the field of global health. Our ‘values’ are not simply words to write down, but they are actions to live by. Find your team. Collaborate. In order to strengthen health systems that work for all, we need diverse, empowered voices on the team. We should continue to ask who is at the table, and perhaps more importantly, who is not at the table; and why. If the table is not big enough, create a new one. Negative emotions can be a powerful tool for deeper and more meaningful discussions and actions, and can lead to positive reform if channeled well. Channel negative emotions into positive strategies and understand that what we feel is “wrong” or “unjust” can go a long way in helping us address the issues we are passionate about. Global health is a complex, dynamic, and fulfilling field. Ultimately, it is up to each of us to be the change we want to see around us: the pandemic has opened a window of opportunity for us to step up and move towards a more just vision for public health. Full article: https://iwghss.org/2021/02/09/iwg-fireside-chat/ Acknowledgements: We would like to thank Dr. Roopa Dhatt, Dr. Rene Loewenson, and Dr. Kabir Sheikh for their meaningful and thoughtful remarks during the IWG Fireside Chat, as well as their feedback on this output: their constructive suggestions and ideas have helped shape the final output published here. We would also like to thank our fellow IWG Global Lecture Series working group members (in alphabetical order): Bronte Davies, Faye Roderos, James Coughlan, Lynn Bust, Mabel Aoun, Meena Taffazoli, Nuria Gallego, Philip Dambisya, Pushpak Mahajan, and Reiner Tamayo. For more information about the IWG, stay connected on our social media platforms: Website, Facebook, Twitter, Instagram. 3 Highlights of the week Global Tax Justice Tax Justice Network - Heads of state launch historic UN plan to stamp out global tax abuse https://www.taxjustice.net/press/heads-of-state-launch-historic-un-plan-to-stamp-out-global-tax- abuse/ “A group of heads of state from around the world are today launching a blueprint for a UN tax convention and a new intergovernmental tax body under the UN to radically tackle rampant global tax abuse, which is currently estimated to cost countries over $427 billion in lost revenues to tax havens every year.
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